Kidney Stones Increase Risk of Adverse Kidney Outcomes

Last Updated: August 31, 2012.
Kidney stones correlate with an increased risk of adverse kidney outcomes, including end-stage renal disease, stage 3b to 5 chronic kidney disease, and sustained doubling of serum creatinine, but increases in absolute rates are small, according to a study published online Aug. 30 in BMJ.

R. Todd Alexander, M.D., Ph.D., from the University of Alberta in Edmonton, Canada, and colleagues conducted a registry cohort study involving 1,954,836 adults (among a total of 3,089,194), without ESRD at baseline or a history of pyelonephritis, to assess whether the presence of kidney stones increases the risk of ESRD or other adverse renal outcomes. Patients were followed up for a median of 11 years.

The researchers found that 0.8 percent of patients had at least one kidney stone; 0.2 percent developed ESRD; 4 percent developed stage 3b to 5 chronic kidney disease, and 0.3 percent experienced sustained doubling of serum creatinine. Compared with those without stones, patients with one or more kidney stone episodes experienced a significantly increased risk of ESRD (adjusted hazard ratio [HR], 2.16); new stage 3b to 5 chronic kidney disease (HR, 1.74); and doubling of serum creatinine (HR, 1.94). The excess risk of adverse outcomes correlating with kidney stones seemed greater for women than for men and for those younger than 50 years than for those aged 50 or older. However, in both sexes and age strata, the risk of all three adverse outcomes was significantly increased for those with at least one episode of stones compared with those without stones, although the absolute increases were small.

"Even a single kidney stone episode during follow-up was associated with a significant increase in the likelihood of adverse renal outcomes including ESRD," the authors write. "However, the increases were small in absolute terms."